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Acute polymyositis after donor lymphocyte infusion
Peng-Chan Lin1, Liang-Tsai Hsiao, Po-Min Chen
1Department of Medical Oncology, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan.
European Journal of Haematology
|January 19, 2005
Summary
Polymyositis as a rare, isolated symptom of acute graft-versus-host disease (GVHD) after donor lymphocyte infusion (DLI) is presented. This case highlights polymyositis as a potential sole indicator of acute GVHD post-DLI.
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- Graft-versus-host disease (GVHD) is a common complication following allogeneic hematopoietic stem cell transplantation (HSCT).
- Polymyositis, a muscle inflammation condition, is typically associated with chronic GVHD.
- Acute GVHD usually presents with distinct symptoms affecting skin, liver, and gut.
Observation:
- A 45-year-old male with acute lymphoid leukemia post-HSCT developed polymyositis 22 days after receiving donor lymphocyte infusion (DLI).
- This patient had no prior acute or chronic GVHD symptoms despite immunosuppression withdrawal.
- Mixed chimerism in bone marrow necessitated DLI for disease remission.
Findings:
- The patient's polymyositis presentation was consistent with acute GVHD.
- This represents a rare instance of polymyositis as the sole manifestation of acute GVHD post-DLI.
- The condition responded well to steroid and cyclosporine A (CsA) treatment.
Implications:
- Polymyositis should be considered in the differential diagnosis of acute GVHD following DLI, even in the absence of other symptoms.
- This case expands the clinical spectrum of acute GVHD manifestations.
- Early recognition and treatment of polymyositis in this context may improve patient outcomes.